Individual provider Active NPI

Jacquelyn Y White, PA-C

  • Physician Assistant
  • Saratoga Springs, NY
National Provider Identifier
1811463102
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022808 Issued in NY
Practice address
211 Church St
Saratoga Springs, NY 12866-1090
Phone
(518) 587-3222
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022808 NY Primary

Addresses

Primary practice location

211 Church St
Saratoga Springs, NY 12866-1090

Mailing address

32 Summerlin Dr
Clifton Park, NY 12065-1687
Phone (518) 369-7025

Other practice location 1

2546 Balltown Rd Ste 300
Schenectady, NY 12309-1079
Phone (518) 377-8184

Other practice location 2

99 E State St Ste G05
Gloversville, NY 12078-1203
Phone (518) 773-2303

Other practice location 3

115 Saratoga Rd Ste 230
Glenville, NY 12302-4226
Phone (518) 348-5300

Other practice location 4

103 Sitterly Rd Ste 2100
Halfmoon, NY 12065-5646
Phone (518) 383-9373

Other practice location 5

425 Guy Park Ave Ste 202
Amsterdam, NY 12010-1044
Phone (518) 842-7088

Other practice location 6

3757 Carman Rd Ste 103
Schenectady, NY 12303-5438
Phone (518) 881-0810

Other practice location 7

23 Arterial Plz # 30-A
Gloversville, NY 12078-2512
Phone (518) 773-2303

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190215000958 NY Practitioner - Physician Assistant 4688912793 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Peter'S Health Partners Medical Associates, P.C.Group PAC ID 6103061189, 480 clinicians

Practice addresses (Care Compare)

2 New Hampshire Ave
Troy, NY 12180-1764
Phone (518) 525-8220

23 Arterial PLZ
30 A
Gloversville, NY 12078-2512
Phone (518) 773-2303

2546 Balltown Rd
Suite 300
Schenectady, NY 12309-1079
Phone (518) 377-8184

Hospital & facility affiliations

  • Ellis Hospital Hospital, Schenectady, NY, CCN 330153
  • St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Health Partners Medical Associates, P.C. Physician Assistant CurrentSince Dec 20, 2021 Accepting new patients
Saratoga Hospital CurrentSince Nov 17, 2018 Accepting new patients
Saratoga Regional Medical , P.C CurrentSince Nov 17, 2018 Accepting new patients
Saratoga Hospital CurrentSince Nov 17, 2018 Accepting new patients
Saratoga Regional Medical , P.C Past Accepting new patients

Locations

425 Guy Park Ave
Ste 202
Amsterdam, NY 12010
Phone (518) 842-3330

23 Arterial Plz
#30A
Gloversville, NY 12078
Phone (518) 773-2303

99 E State St
Ste G5
Gloversville, NY 12078
Phone (518) 773-2303

103 Sitterly Rd
Ste 2100
Halfmoon, NY 12065
Phone (518) 383-9373

2911 State Route 9
Ste 1
Malta, NY 12020
Phone (518) 363-8815

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

2546 Balltown Rd
Ste 300
Schenectady, NY 12309
Phone (518) 377-8184

3757 Carman Rd
Ste 103
Schenectady, NY 12303
Phone (518) 374-7371

115 Saratoga Rd
Ste 230
Schenectady, NY 12302
Phone (518) 348-5300

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: jwhite@caspc.medentdirect.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1811463102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SUMMERLIN DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120651687",
            "telephone_number": "518-369-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CHURCH ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661090",
            "telephone_number": "518-587-3222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2546 Balltown Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123091079",
            "country_code": "US",
            "telephone_number": "518-377-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "99 E State St Ste G05",
            "address_purpose": "LOCATION",
            "city": "Gloversville",
            "state": "NY",
            "postal_code": "120781203",
            "country_code": "US",
            "telephone_number": "518-773-2303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Saratoga Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Glenville",
            "state": "NY",
            "postal_code": "123024226",
            "country_code": "US",
            "telephone_number": "518-348-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Sitterly Rd Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Halfmoon",
            "state": "NY",
            "postal_code": "120655646",
            "country_code": "US",
            "telephone_number": "518-383-9373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 Guy Park Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Amsterdam",
            "state": "NY",
            "postal_code": "120101044",
            "country_code": "US",
            "telephone_number": "518-842-7088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3757 Carman Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123035438",
            "country_code": "US",
            "telephone_number": "518-881-0810",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23 Arterial Plz # 30-A",
            "address_purpose": "LOCATION",
            "city": "Gloversville",
            "state": "NY",
            "postal_code": "120782512",
            "country_code": "US",
            "telephone_number": "518-773-2303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JACQUELYN",
        "middle_name": "Y",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2546 Balltown Rd Ste 300",
            "city": "Schenectady",
            "state": "NY",
            "country_code": "US",
            "postal_code": "123091079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.